Acquired aplastic anemia may be idiopathic or secondary. About 70% of cases are considered idiopathic, without an identifiable cause. The onset of acquired aplas-tic anemia is usually in retrospect gradual, and the symptoms are related to the pancytopenia:
1. Anemia results in pallor, easy fatigability, weakness, and loss of appetite.
2. Thrombocytopenia leads to petechiae, easy bruising, severe nosebleeds, and bleeding into the gastrointestinal and renal tracts.
3. Leukopenia leads to increased susceptibility to infections and oral ulcerations that respond poorly to antibiotic therapy.
4. Hepatosplenomegaly and lymphadenopathy do not occur; their presence suggests an underlying leukemia.
5. Hyperplastic gingivitis is also a symptom of aplastic anemia.
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